Provider Demographics
NPI:1174550347
Name:KREIMAN, RICHARD LOUIS (CRNA, ARNP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LOUIS
Last Name:KREIMAN
Suffix:
Gender:M
Credentials:CRNA, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 GRAND RIDGE RIM WAY
Mailing Address - Street 2:
Mailing Address - City:GARNAVILLO
Mailing Address - State:IA
Mailing Address - Zip Code:52049-8280
Mailing Address - Country:US
Mailing Address - Phone:563-422-8664
Mailing Address - Fax:563-252-1119
Practice Address - Street 1:200 MAIN STREET
Practice Address - Street 2:GUTTENBERG MUNICIPAL HOSPITAL
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-0550
Practice Address - Country:US
Practice Address - Phone:563-252-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000658363L00000X
IAD071989363L00000X, 367500000X
MO2000146350363L00000X, 367500000X
IL041275244367500000X
WI119429030367500000X
TNRN0000135791367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
R78573Medicare UPIN